Smokers who receive intervention in Spanish twice as likely to cease smoking

Smokers who preferred receiving point-of-care services in Spanish were twice as likely to refrain from smoking cigarettes after 6 months compared with those who preferred English, researchers reported in Annals of Family Medicine.

Cigarette smoking is the leading cause of preventable death in the United States. Hispanic individuals make up 18% of the U.S. population, and smoking-related illnesses including cancer, heart disease and stroke are the leading causes of death among this population, Bethany Shorey Fennell, PhD, of the department of health outcomes and behavior at the Moffitt Cancer Center in Tampa, Florida, and colleagues wrote.

Fennell and colleagues sought to examine differences in Quitline treatment enrollment, engagement and smoking cessation outcomes among those who preferred services in Spanish compared with those who preferred English.

Adult participants who presented for care at 13 primary care clinics provided consent to have their contact information sent to an automated Quitline service. Nurses recorded the smoking status of all patients and delivered advice for quitting and offered to send contact information to the Quitline for treatment services.

Rates of treatment enrollment, engagement, acceptance of nicotine replacement therapy, as well as smoking abstinence were compared at 6 months among patients who received services in Spanish and in English. Logistic regression examined language, nicotine replacement therapy and their interaction as predictors of abstinence.

A total of 218,915 patients’ smoking status was assessed and recorded in the electronic health record. Smoking prevalence was 8.4% among patients preferring Spanish and 27% among those who preferred English.

Patients who preferred Spanish were less likely to enroll in treatment, compared with those who preferred English (10.7% vs. 12%), but completed more counseling calls when enrolled in treatment (two vs. one). In addition, those who preferred Spanish were twice as likely to be abstinent from smoking at 6 months, compared with those who preferred English (25.1% vs. 14.5%; OR, 1.98; 95% CI, 1.62-2.40).

The authors noted that nicotine replacement therapy increased abstinence for all patients, and language did not interact with nicotine replacement therapy to predict abstinence.

“This study demonstrates that automated, point-of-care approaches such as [Ask-Advice-Connect] can effectively reach and enroll Spanish-preferring smokers in evidence-based tobacco treatment,” Fennell and colleagues wrote. “Once enrolled, those who received treatment in Spanish had significantly higher rates of treatment engagement, were receptive to accepting [nicotine replacement therapy] when available and had substantially better cessation outcomes.”